Sequestration, I guess, is like a box of chocolates. Well,
sort of. In this case, unfortunately, you know
exactly what you're not going to
get.

In researching our cover story on the sequestration—or, put
in very
stark, black-and-white terms, $85 billion in across-the-board cuts to
federal government spending—and how it is expected to affect biomedical
research
in every state, I was treated to a slew of colorful comparisons by
researchers, trade groups and government leaders, as they grapple to explain
the hit
they will take when the U.S. National Institutes of Health
(NIH) is
forced to cut its budget by 5.1 percent,
or $1.6 billion, this fiscal year.

Scientists have always had a hard time
explaining what they
do to the general public, the media, patients waiting for life-changing
treatments and even lawmakers. Now, more than ever, with
the sequestration wolf
at the door, they are doing whatever they can to effectively translate how
sequestration cuts will affect their research—and
ultimately, the lives of the
patients who stand to benefit from them.

"It's like baking a cake when you are only
given just enough
money to buy flour and sugar, but no eggs," one researcher tells me. Or maybe,
she adds a beat later, "we're like aircraft
carriers—huge beasts that can't
change direction that quickly."

"It's like a faucet," says another
researcher. "We're
turning off the pipeline of new ideas."

And the director of the NIH himself, Francis Collins, compares the potential
impact of sequestration
cuts to NIH funding to a haircut: "We wouldn't do it in a completely blind
fashion like a haircut, but everybody's hair
would get cut—pretty
significantly. There would be a lot of people with very short hair," he says.

As noted in
the story, "'2013: A bad year to have a good
idea,'" (as Dr. Laura Niedernhofer,
associate professor of the Department of
Metabolism & Aging at Scripps Florida, so colorfully puts it), the NIH's
wallet has already been a bit light in the last decade. With
only $30 billion
to ration out to thousands of researchers across the country, the NIH has lost
about 20 percent of its purchasing power since 2003,
thanks to flat budgets
that have been eroded by inflation, says Collins.

Always generous with his
response to my interview requests,
Dr. Curt Civin, associate dean of Research at the University of Maryland School
of Medicine and director of the Institute for Stem Cell Biology & Regenerative Medicine,
shares that his very
decorated research career wouldn't have been possible
without NIH funding. His breakthrough discovery of the CD34
lympho-hematopoietic stem cell
antigen and monoclonal antibody has facilitated
basic research in stem cell biology and leukemia, leading to improved stem cell
transplantation for
thousands of patients. He doesn't even know the total
amount of NIH funding that enabled such discoveries of his—"it's millions and
millions of
dollars," he offers—but Civin tells me that he isn't as much
concerned with the impact the NIH cuts will have on veteran researchers like
himself.
He's more concerned about "the young whipper-snappers."

"It's like the old story about two people trying to
cross a
river over a bunch of stones. One person leaps between the stones. The other
one fills in the stones so it's easier for everyone to walk
across. If you
don't have a young investigator, you can't leap as far," he says. "We're
turning off our future."

Like the faucet Civin describes above.

And what's more, when faced with a lack of financial support
for their
research, young scientists will likely be enticed by opportunities in
other countries that are increasingly investing in biomedical research, Civin
predicts.

This trend, which is often referred to as "the brain drain,"
is also affecting the laboratory of Dr.
Kerri A. Mowen, assistant professor in
the Departments of Chemical Physiology & Immunology and Microbial Sciences
at the Scripps Research Institute in La Jolla, Calif. Mowen, who offers the
cake-baking
analogy above, tells me she is already losing colleagues to South
Korea, Singapore and India.

"Those places are increasing their investments in research.
And thus, we're cutting diversity out of our research community, which I think
is
important," Mowen says.

"I'm very cynical about all of this," Mowen confesses, and
she's clearly been
giving a lot of thought to the sequestration, as she is full
of colorful analogies about the situation: "It's like the story of Darwin's
finches.
The beaks of the finches on one island are all one size because they
adapted over the years in order to get certain types of fruit. I fear that this
is
what will happen here; that we will end up with a lot finches with the same
type of beak," she says.

Obviously,
the NIH isn't the only government entity being
asked to tighten its belt. Some of you who may be traveling this conference
season have likely had your
flights delayed, as airports are putting fewer
aircraft controllers on duty. More than half of the nation's 2.1 million
government workers may be
required to take furloughs if agencies are forced to
trim budgets. About 70,000 students enrolled in pre-kindergarten programs may
be cut from them,
and 14,000 teachers could lose their jobs. And if you're
planning a family summer vacay to one of our national parks, you're likely to encounter
shorter visitor hours, fewer rangers, locked restrooms and overflowing trash
cans.

But cutting funding for the
NIH? It's not the same thing,
argue Civin and Mowen.

"This funding is important to our health and our jobs, and
it makes no sense to include them in these across-the-board cuts," says Civin.

"All cuts are not
created equal," Mowen agrees. "That is
where the failing really is in the sequestration. From where I sit, I haven't
seen many signs of hope that
the powers that be are making decisions based on
evidence. If I were the owner of a small business, I wouldn't make decisions
that cause my business
to shut down. We have to recognize which parts of the
budget are investments, and what will lead to economic growth. That is what we
really need to get
out of this entire situation."

At press time, President Barack Obama released a 2014 budget
proposal that seeks
to cancel sequestration and replace it with an additional
$1.8 trillion in deficit reduction through new revenue, $400 billion in savings
and $200
billion in discretionary cuts split evenly between defense and
nondefense programs in 2017. That budget provides $31 billion for the NIH, a
slight
increase over the pre-sequestration amount provided for the agency.

"Some of the projections for
next year are that we could get
back to the budget that we had last year—and we should appreciate that as a
victory," Civin commiserates.

It's clear that the sequestration cuts will affect how many
research projects are funded, the ability to hire
qualified and talented staff
in laboratories in every state and even the amount of equipment and tools that
labs are able to purchase. But ultimately,
the pinch that biomedical
researchers are feeling now will be felt later by the patients who would have
benefitted from important advances in diseases
that are becoming epidemics in
our country, like diabetes, Alzheimer's disease and even cancer. Is it really
fair to ignore this stark reality and put
medical research in the same category
as killing weeds in a public park?

Perhaps Mowen puts it best: "I feel that
as scientists, we
haven't done a very good job at communicating what we do. The bottom line is,
when you go to the pharmacy to pick up a prescription,
you have the NIH—and the
funding it gave to the research that went into creating that drug 15 to 20
years ago—to thank for it," she says.